Gout, despite being one of the most well-known and recognizable rheumatic diseases, still has large populations of people struggling with its management, as they do not receive urate-lowering treatment, even when they qualify. Of those who receive this treatment, only a small percentage reach their target urate goal. To shed some light on this, we’ve invited Dr. Nicola Dalbeth, a Specialist Rheumatologist, who leads research on the mechanisms, impact and treatment of gout. Dr. Dalbeth is also a principal investigator of trials for novel therapeutic agents and treatment strategies in gout and in 2020, was also a member of the core oversight committee for the ACR Gout Management Guidelines. We discuss treatment efficacy, the disparities, myths and barriers to them, diagnosis, and strategies regarding management of gout.